BLUNT CHEST TRAUMA

Cardiac Enzymes
No value. Definitely do not use in asymptomatic patients.
ECHO
Not useful. If patient is asymptomatic who cares? If symptomatic with
hypotension just treat as RV failure. If cardiology is consulted they will
probably ECHO.
4. Which patients who are post blunt chest trauma need admission?
Cardiac complications - Abn ECG Yes if new. Don't do the ECHO
Do you think all of the above cardiac ones require continuous ECG
monitoring? Yes. Serial ECGs.
Blunt Thoracic Aortic Trauma
My understanding is that by the time they get to hospital the patient is
usually dead if the Thoracic Aorta is the cause / the hypotension is due to
something else. True.
2, Is there any role for an on-table TOE? Dave Feliciano recently said this
can be of use to the surgeon who is busy in the abdomen. May redirect
thinking and prioritization.
R. Smith, MD
Cook County Trauma
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